title: Paediatric dentistry discussion paper and case report. Management of small carious lesions in primary teeth: caries removal versus fluoride application and periodic 'observation' until exfoliation.
abstract: Differences in treatment rationale exist between dental practitioners with respect to the management of small carious lesions in primary teeth. Some do not consider it necessary to use a conventional restorative approach, preferring to apply topical fluoride and/or 'monitor' the lesion(s). This paper advocates the alternative approach which entails complete caries removal by mechanical means, the rationale being to eliminate the pool of cariogenic microorganisms and thereby protect sound teeth from succumbing to carious attack. A case is presented to illustrate the extent to which caries can progress and also involve other teeth if small cavitated lesions are simply treated by 'spot' application of fluoride. Clinical treatment of caries must be based on scientific knowledge of the microorganisms involved and an understanding of its transmissible and infectious nature.
authors.affiliation: School of Oral Health Sciences, University of Western Australia.
authors.forename: T
authors.initials: T
authors.lastname: Gotjamanos
mesh_terms: D002675:Child, Preschool; D019140:Dental Care for Children; D003731:Dental Caries / Q000628:therapy*; D003793:Dental Restoration, Permanent / Q000706:statistics & numerical data*; D005460:Fluorides, Topical / Q000627:therapeutic use*; D006801:Humans; D008297:Male; D019239:Practice Patterns, Dentists'; D012969:Sodium Fluoride / Q000627:therapeutic use; D014094:Tooth, Deciduous
chemical_list: D005460:Fluorides, Topical; C023807:sodium fluoride topical preparation; D012969:Sodium Fluoride